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1.

Introduction:

The phlebotomists’ procedures are a still source of laboratory variability. The aim of this study was to verify the efficacy of minor modification in procedure for collection of diagnostic blood specimens by venipuncture from CLSI H03-A6 document is able to reduce the tourniquet application time.

Materials and methods:

Thirty phlebotomists were invited to participate. Each phlebotomist was trained individually to perform the new venipuncture procedure that shortens the time of tourniquet release and removal. The phlebotomy training program was delivered over 8h. After training, all phlebotomists were monitored for 20 working days, to guarantee the adoption of the correct new procedures for collection of diagnostic blood specimens. After this time frame the phlebotomists were evaluated to verify whether the new procedure for blood collection derived from CLSI H03-A6 document was effective to improve the quality process by decrease in tourniquet application time. We compared the tourniquet application time and qualitative difference of phlebotomy procedures between laboratories before and after phlebotomy training.

Results:

The overall mean ± SD tourniquet application time before and after this intervention were 118 ± 1 s and 30 ± 1 s respectively. Minor modifications in procedure for blood collection were able to reduce significantly the tourniquet application time (−88 s, P < 0.001).

Conclusions:

The minor modifications in procedure for collection of diagnostic blood specimens by venipuncture from CLSI H03-A6 document were able to reduce the tourniquet application time. Now the proposed new procedure for collection of diagnostic blood specimens by venipuncture could be considered usefulness and should be put into practice by all quality laboratory managers and/or phlebotomy coordinators to avoid preanalytical errors regard venous stasis and guarantee patient safety.  相似文献   

2.

Introduction:

Proper preparation of the individual is a key prerequisite for ensuring the quality of laboratory testing. Our hypothesis was that many outpatients are not sufficiently familiar with the correct way of preparing for the laboratory tests, for which the individual needs to be at fasting. This study aimed to investigate: i) whether patients are aware of how they need to prepare properly for laboratory tests; ii) the way in which users are informed about how to prepare for laboratory testing; and iii) whether users arrive to the laboratory for phlebotomy properly prepared.

Materials and methods:

An anonymous questionnaire was conducted on 150 outpatients older than 18 years, during February 2013. The response rate was 11%. All patients were interviewed by the laboratory staff. Patients were informed about detail of the questionnaire and agreed to participate in the survey.

Results:

Out of the total number subjects, 39% were fully aware of the proper definition of the fasting, whereas even 46% subjects replied that the last meal has to be taken the day before and the exact time that must pass after the last meal to blood sampling is not important. Furthermore, 52% subjects did not receive any information about how they need to prepare themselves properly for blood testing. Only 60% of them came properly prepared for the laboratory blood testing.

Conclusions:

Substantial proportion of patients do not come properly prepared for laboratory testing. We conclude that patients are not well informed about the fasting requirements for laboratory blood testing. Moreover, requesting physician is the preferred source of information from which patients learn how to prepare themselves for phlebotomy.  相似文献   

3.
We performed a pilot accuracy study on glucometers from three sources: “Advantage” from Boehringer Mannheim (A), “Glucometer* 4” from Bayer (B) and “One Touch Basic” from Life Scan (C) and compared these results with the results on autoanalyzers-Dimension RxL (1) and Hitachi 704 (2). Each glucometer was tested with venous blood in duplicate, from three different groups of 20 patients each, at random, on three different days, in our outpatient phlebotomy section. The rest of the sample was collected into heparinized tubes & the plasma separated within 15 minutes of sample collection & analyzed on both the analyzers in duplicates. The data were analyzed for accuracy by tabulating the number and percentage of test values that vary from the analyzer (reference) method by 10% or less, by 10% to 20%, or greater than 20% and the results tabulated on the Accuracy Study Table. This being a pilot study and the numbers being small, it may be suggested from the Accuracy Study Table alone, that the results of glucose in whole blood done with glucometer (A) were comparable with that of plasma values without applying any factor; whereas the results with glucometers (B) & (C) need to be divided by 1.11 to be comparable with plasma results; statistically though, results with glucometer (C) were comparable with or without factor. Patients using glucometers need to be alerted about the variance in their glucose results when compared to laboratory results, more clearly by the respective companies in their product inserts. An external quality control material that is glucometer method specific is needed, so that the Clinical Biochemistry laboratory in any hospital setup can more effectively monitor the performance of the glucometers in the wards periodically.  相似文献   

4.
We present an integrated microfluidic device capable of performing single-stranded DNA (ssDNA) preparation and magnetic bead-based microarray analysis with a white-light detection for detecting mutations that account for hereditary hearing loss. The entire operation process, which includes loading of streptavidin-coated magnetic beads (MBs) and biotin-labeled polymerase chain reaction products, active dispersion of the MBs with DNA for binding, alkaline denaturation of DNA, dynamic hybridization of the bead-labeled ssDNA to a tag array, and white-light detection, can all be automatically accomplished in a single chamber of the microchip, which was operated on a self-contained instrument with all the necessary components for thermal control, fluidic control, and detection. Two novel mixing valves with embedded polydimethylsiloxane membranes, which can alternately generate a 3-μl pulse flow at a peak rate of around 160 mm/s, were integrated into the chip for thoroughly dispersing magnetic beads in 2 min. The binding efficiency of biotinylated oligonucleotides to beads was measured to be 80.6% of that obtained in a tube with the conventional method. To critically test the performance of this automated microsystem, we employed a commercial microarray-based detection kit for detecting nine mutation loci that account for hereditary hearing loss. The limit of detection of the microsystem was determined as 2.5 ng of input K562 standard genomic DNA using this kit. In addition, four blood samples obtained from persons with mutations were all correctly typed by our system in less than 45 min per run. The fully automated, “amplicon-in-answer-out” operation, together with the white-light detection, makes our system an excellent platform for low-cost, rapid genotyping in clinical diagnosis.  相似文献   

5.
The evidence-based paradigm has changed and evolved medical practice. Phlebotomy, which dates back to the age of ancient Greece, has gained experience through the evolution of medicine becoming a fundamental diagnostic tool. Nowadays it connects the patient with the clinical laboratory dimension building up a bridge. However, more often there is a gap between laboratory and phlebotomist that causes misunderstandings and burdens on patient safety. Therefore, the scope of this review is delivering a view of modern phlebotomy to “bridge” patient and laboratory. In this regard the paper describes devices, tools and procedures in the light of the most recent scientific findings, also discussing their impact on both quality of blood testing and patient safety. It also addresses the issues concerning medical aspect of venipuncture, like the practical approach to the superficial veins anatomy, as well as the management of the patient’s compliance with the blood draw. Thereby, the clinical, technical and practical issues are treated with the same relevance throughout the entire paper.Key words: phlebotomy, venipuncture, laboratory testing, preanalytical phase, preanalytical variability, patient safety, evidence based medicine  相似文献   

6.
Phlebotomy is one of the most complex medical procedures in the diagnosis, management and treatment of patients in healthcare. Since laboratory test results are the basis for a large proportion (60–80%) of medical decisions, any error in the phlebotomy process could have serious consequences. In order to minimize the possibility of errors, phlebotomy procedures should be standardised, well-documented and written instructions should be available at every workstation. Croatia is one of the few European countries that have national guidelines for phlebotomy, besides the universally used CLSI (Clinical Laboratory Standards Institute) H3-A6 Procedures for the Collection of Diagnostic Blood Specimens by Venipuncture; approved Standard-Sixth Edition (CLSI, 2007) and WHO (World Health Organization) guidelines on drawing blood: best practices in phlebotomy (WHO, 2010). However, the growing body of evidence in importance of preanalytical phase management resulted in a need for evidence based revision and expansion of existing recommendations.The Croatian Society for Medical Biochemistry and Laboratory Medicine, Working Group for the Preanalytical Phase issued this recommendation. This document is based on the CLSI guideline H3-A6, with significant differences and additional information.  相似文献   

7.
Essential hypertension (EH) is a multifactorial and complex disease with high rate of incidence and associated co-morbidities. Previous studies do not provide unanimous results for the risk of hypertension and association with Fok I genotype frequency and serum vitamin D levels. Hence, this study was undertaken to determine the status of Fok I vitamin D receptor (VDR) gene polymorphism along with vitamin D levels and blood pressure in patients with EH. Four hundred (200 controls and 200 cases of essential hypertension) participants from general Indian population were enrolled in this study. Peripheral blood samples were collected for genotyping Fok I-VDR gene polymorphism using PCR–RFLP method whereas 25-OH vitamin D levels in serum were quantified using high performance liquid chromatography (HPLC). Significantly reduced 25-OH vitamin D levels were observed in patients with EH (24.04 ± 8.62 vs 50.46 ± 15.46) compared to control subjects (p = 0.0001). Homozygous recessive genotype ‘ff’ frequency was increased by 8.06 fold (CI: 3.71–17.47, p = 0.0001) in patients with EH compared to dominant ‘FF’ genotype frequency. In conclusion, recessive ‘ff’ genotype frequency correlates with reduced serum vitamin D levels and results in significantly increased systolic and diastolic blood pressures leading to predisposition of EH.  相似文献   

8.
[目的/意义]针对同一事件新闻报道与舆情评论既相互依存又偏离的现象,通过话题识别与主题关联分析,探索新闻报道引发的舆情评论在主题内容与时间阶段上的异同,拟为研究以舆情评论表达的舆情事件和以新闻报道表达的社会现实之间的共振与偏离,进而为探究社会舆情传播规律提供参考,为服务政府科学决策提供依据。[方法/过程]以拉斯韦尔（5W）模型、LDA主题模型和Python工具为基础,设计研究思路和流程,从腾讯新闻和知乎平台上抓取新闻报道和评论的数据,经过处理加工过后加以分析挖掘。[结果/结论]研究发现：舆情事件主题会一定程度偏离社会现实主题,衍生出更多隐性主题;舆情事件与社会现实的发展走向较一致;此外,社交媒体相较于新闻媒体所衍生的舆情事件主题更多,而两者反映的社会现实主题类似。  相似文献   

9.
Procedures involving phlebotomy are critical for obtaining diagnostic blood specimens and represent a well known and recognized problem, probably among the most important issues in laboratory medicine. The aim of this report is to show spurious hyperkalemia and hypocalcemia due to inadequate phlebotomy procedure. The diagnostic blood specimens were collected from a male outpatient 45 years old, with no clinical complaints. The tubes drawing order were as follows: i) clot activator and gel separator (serum vacuum tube), ii) K3EDTA, iii) a needleless blood gas dedicated-syringe with 80 I.U. lithium heparin, directly connected to the vacuum tube holder system. The laboratory testing results from serum vacuum tube and dedicated syringe were 4.8 and 8.5 mmol/L for potassium, 2.36 and 1.48 mmol/L for total calcium, respectively. Moreover 0.15 mmol/L of free calcium was observed in dedicated syringe. A new blood collection was performed without K3EDTA tube. Different results were found for potassium (4.7 and 4.5 mmol/L) and total calcium (2.37 and 2.38 mmol/L) from serum vacuum tube and dedicated syringe, respectively. Also free calcium showed different concentration (1.21 mmol/L) in this new sample when compared with the first blood specimen. Based on this case we do not encourage the laboratory managers training the phlebotomists to insert the dedicated syringes in needle-holder system at the end of all vacuum tubes. To avoid double vein puncture the dedicated syringe for free calcium determination should be inserted immediately after serum tubes before EDTA vacuum tubes.  相似文献   

10.

Introduction:

The activities involving phlebotomy, a critical task for obtaining diagnostic blood samples, are poorly studied as regards the major sources of errors and the procedures related to laboratory quality control. The aim of this study was to verify the compliance with CLSI documents of clinical laboratories from South America and to assess whether teaching phlebotomists to follow the exact procedure for blood collection by venipuncture from CLSI/NCCLS H03-A6 - Procedures for the Collection of Diagnostic Blood Specimens by Venipuncture might improve the quality of the process.

Materials and methods:

A survey was sent by mail to 3674 laboratories from South America to verify the use of CLSI documents. Thirty skilled phlebotomists were trained with the CLSI H03-A6 document to perform venipuncture procedures for a period of 20 consecutive working days. The overall performances of the phlebotomists were further compared before and after the training program.

Results:

2622 from 2781 laboratories that did answer our survey used CLSI documents to standardize their procedures and process. The phlebotomists’ training for 20 days before our evaluation completely eliminated non-conformity procedures for: i) incorrect friction of the forearm, during the cleaning of the venipuncture site to ease vein location; ii) incorrect sequence of vacuum tubes collection; and iii) inadequate mixing of the blood in primary vacuum tubes containing anticoagulants or clot activators. Unfortunately the CLSI H03-A6 document does not caution against both unsuitable tourniquet application time (i.e., for more than one minute) and inappropriate request to clench the fist repeatedly. These inadequate procedures were observed for all phlebotomists.

Conclusion:

We showed that strict observance of the CLSI H03-A6 document can remarkably improve quality, although the various steps for collecting diagnostic blood specimens are not a gold standard, since they may still permit errors. Tourniquet application time and forearm clench should be verified by all quality laboratory managers in the services. Moreover, the procedure for collecting blood specimens should be revised to eliminate this source of laboratory variability and safeguard the quality.  相似文献   

11.
This paper reports an innovative technique for reagents storage in microfluidic devices by means of a one-step UV-photoprintable ionogel-based microarray on non-modified polymeric substrates. Although the ionogel and the ink-jet printing technology are well published, this is the first study where both are used for long-term reagent storage in lab-on-a-chip devices. This technology for reagent storage is perfectly compatible with mass production fabrication processes since pre-treatment of the device substrate is not necessary and inkjet printing allows for an efficient reagent deposition process. The functionality of this microarray is demonstrated by testing the release of biotin-647 after being stored for 1 month at room temperature. Analysis of the fluorescence of the ionogel-based microarray that contains biotin-647 demonstrated that 90% of the biotin-647 present was released from the ionogel-based microarray after pumping PBS 0.1% Tween at 37 °C. Moreover, the activity of biotin-647 after being released from the ionogel-based microarray was investigated trough the binding capability of this biotin to a microcontact printed chip surface with avidin. These findings pave the way for a novel, one-step, cheap and mass production on-chip reagents storage method applicable to other reagents such as antibodies and proteins and enzymes.  相似文献   

12.
Analytical functioning of a point-of-care analyzer, i-Smart 30 (i-sens: Seoul, South Korea), for electrolyte quantification was investigated at Sant Parmanand Hospital, a tertiary-care hospital in Delhi, India. Samples that were received for electrolyte assay were assayed, double-blinded for their Na and K level using the arterial blood gas analyzer, the ABL 555 (Radiometer, Copenhagen) and the i-Smart 30 electrolyte analyzer. There was satisfactory correlation between the results obtained with the two analyzers with an encouraging bias, standard deviation and the 95 % limits of agreement between the data generated for Na and K levels. The performance of the i-Smart 30 would be satisfactory during the point-of-care measurements of Na and K levels in emergency rooms and clinical laboratories with inadequate infrastructure only if its day-to-day performance was monitored to ensure reliability of the generated reports.  相似文献   

13.
信息查新咨询结论实例分析   总被引：1，自引：0，他引：1  
李欣欣  张云秋 《情报科学》1999,17(5):554-556
本文通过对16份来自全国机构的查新报告进行归纳、分析,总结出撰写查新结论常用的三段式及其特点,并针对报告中出现的问题进行探讨,期望通过实例分析,进一步贯彻《细则》中的规范化要求,提高查新结论撰写的质量。  相似文献   

14.
大众传媒在国家形象的外显和传播过程中,是影响受众最有效的途径。全球媒体事件(如奥运会)通过媒体聚焦,在短时间内对国家形象的改变产生影响。作者以11,636篇国内外英文媒体对五个奥运举办城市的报道全文为分析对象,通过社会网络分析方法,借助数据挖掘软件,对文献的主题词进行统计分析。数据显示,有关北京奥运会的报道共涉及592个议题,核心议题主要集中在政治、经济发展和环境保护等领域,且议题呈逐年增加趋势。  相似文献   

15.
Matrix metalloproteinase [MMP]-2 and tissue inhibitor of metalloproteinase [TIMP]-2 are emerging as pivotal players in inflammation and carcinogenesis. The present study aimed to evaluate the role of MMP-2 (−735C > T) [rs 2285053] and TIMP-2 (−418G > C) [rs 8179090] gene polymorphisms in cervical cancer susceptibility in Indian women. We recruited 200 cervical cancer patients from North India and 200 unrelated, age-matched, cancer-free healthy female controls of similar ethnicity. Genomic DNA extraction from peripheral blood samples, collected from the study subjects, was carried out using salting-out method. MMP-2 and TIMP-2 genotyping was performed using polymerase chain reaction-based restriction fragment length polymorphism. Our findings demonstrated no significant association between MMP-2 (−735C > T) and TIMP-2 (−418G > C) gene polymorphisms and the risk of developing cervical cancer in the study population. Further stratified analysis using a case-only study approach revealed that there was no effect of MMP-2/TIMP-2 polymorphisms on early and advanced stages of cervical cancer. Further MMP-2 and TIMP-2 polymorphisms did not modulate the risk in cervical cancer patients who smoked tobacco/cigarettes. Overall, the present study demonstrated a lack of association between MMP-2 and TIMP-2 gene polymorphisms and cervical cancer susceptibility in women of Northern India.  相似文献   

16.
许燕  麻思蓓  郑彦宁 《科研管理》2022,43(2):170-175
   提高科技报告质量是实现科技资源有效积累、促进科技信息高效传播、提高科技成果转化应用的重要方式。构建融入科研管理流程的科技报告质量控制机制,将科技报告撰写主体、管理主体、评价主体行为纳入统一的科研管理平台,对科技报告进行精细化审核与评价。审核、评价行为将直接决定科技报告质量、科研项目进程与科研绩效。将科技报告质量控制与科研管理相融合能够实现对科技报告撰写、审核、评价行为的有效统一与衔接,达到降低管理成本,提高工作效率,实现科技报告质量有效控制的目的。  相似文献   

17.
The objective of the present study was to investigate the antioxidant status and the extent of oxidative DNA damage in lymphocytes and their relation with essential hypertension (EHT). A total of 100 South Indian subjects aged 30–65 were included for the study. Of these 50 were normotensive controls (group-1) with blood pressure ≥120/80 mm Hg, 50 were newly diagnosed (group-2) and were not on any antihypertensive drugs, but had systolic blood pressure ranging between 140 and 160 mmHg and diastolic blood pressure 95–100 mmHg and 50 newly diagnosed essential hypertensive patients underwent drug therapy for 1 year was considered as group-3. Enzymatic and non-enzymatic antioxidants significantly decreased and lymphocyte DNA damage was significantly increased in newly diagnosed hypertensive patients compared with control group. The major decrease in DNA damage and significant improvement in enzymatic and non-enzymatic antioxidants were observed after 1 year of antihypertensive therapy in treated group compared with newly diagnosed hypertensive patients. Total antioxidant status and lymphocyte DNA damage showed a strong negative correlation in all the three groups. Essential hypertension associated with oxidative stress which in turn causes genotoxic susceptibility to variety of disease including cancer. In the absence of DNA repair process and DNA checkpoint mechanisms, the genomic integrity is susceptible to extensive damage. In our study, increased oxidative DNA damage and decreased antioxidant levels were frequently observed in the newly diagnosed essential hypertensive patients, suggesting that oxidative stress is important in the pathogenesis of EHT. Therefore, the present study has additional clinical implication. Further investigations with large number of patients along with antioxidant supplement are highly warranted.  相似文献   

18.
【目的】 分析医学学报类期刊被中国科学引文数据库（CSCD）引用的情况及特点,为办好医学学报提供思路。【方法】 选择被CSCD和《中文核心期刊要目总览》共同收录的16种医学学报,检索得到16种医学学报2013—2015年发表的论文被CSCD收录期刊引用的施引文献列表,分析施引文献的发表期刊、语种分布、作者机构及研究方向。【结果】 自身施引在该类期刊被CSCD引用中占主导作用,很少有CSCD收录的英文期刊施引该类期刊,本机构作者施引对其被引的贡献较大。施引文献研究方向除内科学、肿瘤学和外科学外,还有一些医学交叉学科。【结论】 医学学报需要继续扩大影响力,特别是对非本机构作者;加大宣传力度提高被引机会;注意重点、交叉学科和科研机构,从而提升质量、稳定发展。  相似文献   

19.
This study investigated more attributes of online searchers that were believed to affect the quality of their search results. Subjects were selected from the online searching courses in six library schools. The searching proficiency of the subjects was measured by their performance on two DIALOG searches. Their creativity level was measured using two self-report inventories; their intelligence level was approximated from their GRE Verbal and Quantitative scores; and their personality traits in regard to masculinity, femininity, and self-esteem were measured using the Interpersonal Disposition Inventory. The large number of independent, predictor variables were reduced by factor analysis and the derived factors were related to the dependent variable, online searching performance, in a multiple regression analysis. The findings suggest that differences in searching performance can be attributed, to a small degree only, to general verbal and quantitative aptitude, artistic creativity, and to an inclination toward critical and analytical creative thinking. The findings also raise doubts, however, that high intelligence and other attributes cited by writers in the field are necessary for high performance. The notion that searching performance can be predicted by or is dependent upon certain cognitive or personality traits has thus become highly suspect.  相似文献   

20.
The apo E gene located on chromosome 19 in humans is polymorphic. The three apo E isoforms E2, E3, and E4 are coded by three common alleles of the gene. The amyloid plaques in brains of Alzheimer disease (AD) patients are known to contain apo E. There is an increased prevalence of E4 allele in AD patients. apo E exhibits increased binding to a peptide Aβ deriving from amylold precursor protein. apo E, the risk factor for late AD disease is unable to prevent formation of paired helical filaments which in turn destabilizes neuronal microtubules. A variety of molecular techniques are available for apo E genotyping using DNA amplified by the polymerase chain reaction (PCR). The high guanine to cytosine content of apo E is problematic to the extent that the yield of PCR product and hybridization stringency can be compromised. The specificity of diagnosis of late-onset AD can be improved when results of apo E genotyping are evaluated together with clinical criteria.  相似文献   

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